American journal of surgery
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It was hypothesized that routine operative drainage is unnecessary for elective hepatic resection. ⋯ The 84% of patients not operatively drained had no greater adverse outcome. After hepatic resection, routine drainage of the abdomen is unnecessary.
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While on surgical rotations, clinical clerks spend more time on the ward and in the emergency department than in any other location. Consequently, their in-house experience is of great importance to their education-yet the teaching processes in these settings have never been fully explored. Unlike the structured pre-clerkship years, the exact breakdown of a clerk's hospital-based education is difficult to elucidate. To effectively evaluate a clerkship curriculum, it is essential to know what clerks are being taught outside of seminars, how that teaching occurs, and by whom. This study proposes a methodology by which a surgical clerkship curriculum can be evaluated. ⋯ Informal teaching of surgery clerks is variable and occurs through multiple short encounters in many settings and by various trainees. Efforts to improve the teaching process should focus on providing formal teaching instruction early in residency, specifically geared toward short encounters in flexible settings. Both the operating room as a learning environment and staff surgeons as informal teachers must be intentionally integrated into the teaching process.
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America faces an impending national crisis as fewer nurses are being trained and fewer are remaining active in the nursing profession. By improving our attitudes toward nurses and by offering educational incentives, we may still be able to provide enough nurses to avoid a catastrophic nursing shortfall.